Florida health system wants vendors that insure workers

A breast surgeon's idea about how to address the problem of the growing number of uninsured patients has taken root in Florida, inspiring the health system where he practices to declare that it will give preferential treatment to vendors that provide health insurance to their employees.

Following a suggestion by Robert DerHagopian, MD, the board of Baptist Health South Florida on Nov. 2 adopted a policy to use its market clout to press the issue of the uninsured by pressuring the companies it does business with to engage in "socially responsible" behavior by offering their employees health insurance.

The Coral Gables-based health system, with five hospitals and 12 outpatient facilities, has about 10,000 vendors and bills itself as the largest private employer in the area. Leaders said the policy, for which details have not yet been worked out, likely would be implemented in January 2007.

"This increases the pool of patients who are insured ... and when you think about it, it's the right thing to do," said Dr. DerHagopian, who came up with the idea after thinking about how lawmakers in his home state of Massachusetts mandated health insurance coverage for all citizens.

Whether Dr. DerHagopian's market-based approach makes a difference remains to be seen. But at the very least, leaders say, the initiative sends a message that the growing uninsured population -- estimated at 46 million people nationwide -- is a problem that should be taken seriously.

"This could be a very strong philosophical statement, because we do business with just about everyone down here," said Brian E. Keeley, president and chief executive officer of the health system.

Keeley first discussed the idea with Dr. DerHagopian a few months ago and then brought it up at community business group meetings. Members of the audience -- which included several businesses that could be affected by the policy -- cheered his remarks. Since then, he has received nearly 100 e-mails from people and other hospital leaders about the idea.

Baptist Health is not the only hospital or health system to take this kind of approach, though such policies are fairly uncommon. Rick Wade, spokesman for the American Hospital Assn., said that in the last five years he has heard of a few faith-based health systems taking similar steps. He said Baptist Health's policy could help inspire others to follow suit.

"The South Florida action will remind an awful lot of hospitals that they have value systems that it may be desirable to let the public know about," Wade said.

If it succeeds, the policy actually could provide a financial benefit to the health system, said Paul Ginsburg, PhD, president of the Center for Studying Health System Change.

The benefit could come because the hospital "probably perceives that many of those who work for vendors live within range of the hospital, and this might be the difference in some of them showing up as insured or uninsured patients," he said.

Whether it actually persuades vendors and other businesses to offer health coverage to employees will depend on the companies involved and the competitive market for those businesses, Dr. Ginsburg added.

Keeley said the policy, which also would give preferential treatment to local businesses, would be applied not only to medical suppliers but also to contractors, consultants and any other company doing business with Baptist Health.

He hopes the action will make a dent in what he sees as an unhealthy, unsustainable trend in health care.

"Sometimes it starts with a little kernel of an idea," Keeley said. "Maybe we can start a movement in the market itself."